Optimal Surgical Strategies in Patients With T1 and T2 Gallbladder Cancer: necessity of Lymph Node Dissection and Liver Resection: a Retrospective Cohort Study.

Background: The optimal surgical extent for T1 and T2 gallbladder (GB) cancer remains debated. This study aimed to evaluate the impact of lymph node (LN) dissection and liver resection on survival outcomes in T1 and T2 GB cancer.

Methods: From 2010 to 2018, a retrospective analysis was conducted on 419 patients with pathologically confirmed T1 and T2 GB cancer who underwent curative surgery at a tertiary institution.

Synthetic data generation method improves risk prediction model for early tumor recurrence after surgery in patients with pancreatic cancer.

Pancreatic cancer is aggressive with high recurrence rates, necessitating accurate prediction models for effective treatment planning, particularly for neoadjuvant chemotherapy or upfront surgery. This study explores the use of variational autoencoder (VAE)-generated synthetic data to predict early tumor recurrence (within six months) in pancreatic cancer patients who underwent upfront surgery. Preoperative data of 158 patients between January 2021 and December 2022 was analyzed, and machine learning models-including Logistic Regression, Random Forest (RF), Gradient Boosting Machine (GBM), and Deep Neural Networks (DNN)-were trained on both original and synthetic datasets.

Optimal Number of Lymph Nodes Retrieved to Lower the Risk of False N0 for Patients with Pancreatic Cancer Undergoing Curative Surgery.

Background: Accurate LN examination is critical for staging and prognosis in pancreatic cancer. However, the ideal number of LNs required for precise staging and improved survival remains unclear. This study aimed to determine the optimal number of lymph nodes (LNs) to retrieve during pancreatectomy for pancreatic cancer to minimize false node-negative (false N0) rates and assess its impact on survival outcomes.

Five-year survival of patients with hilar cholangiocarcinoma: a single-center retrospective study.

Purpose: Hilar cholangiocarcinoma is known for its poor prognosis due to late diagnosis. To achieve long-term survival, curative resection often is necessary. However, after surgical resection, the 5-year survival rates vary from 14% to 48%.

The impact of distress at diagnosis in patients with pancreatic cancer undergoing pancreatectomy.

Background: Cancer-related distress is associated with low quality of life and oncologic outcomes in cancer patients. At present, there are limited data regarding the clinical implications of distress in patients with pancreatic cancer. The present study aimed to investigate the association between distress at diagnosis and the surgical outcomes of patients with curative-intent surgery for pancreatic cancer.

Artificial Intelligence-Powered Spatial Analysis of Immune Phenotypes in Resected Pancreatic Cancer.

Importance: Although tumor-infiltrating lymphocytes (TILs) have been implicated as prognostic biomarkers across various malignancies, the clinical application remains challenging. This study evaluated the applicability of artificial intelligence (AI)-powered spatial mapping of TIL density for prognostic assessment in resected pancreatic ductal adenocarcinoma (PDAC).

Objective: To evaluate the prognostic significance of AI-powered spatial TIL analysis in resected PDAC and its clinical applicability.

Impact of preoperative prognostic factors on survival outcomes in intrahepatic cholangiocarcinoma: a retrospective cohort study.

Purpose: This study assesses preoperative prognostic factors in intrahepatic cholangiocarcinoma (ICC) to improve risk assessment and inform clinical decisions, focusing on the role of lymph node dissection (LND).

Methods: We conducted a retrospective analysis of 234 patients who underwent surgery for ICC at a single institution between 2010 and 2019. Prognostic factors affecting overall survival (OS) were identified through univariate and multivariable logistic regression analyses.

Development and External Validation of a Nomogram Predicting Early Recurrence of Gallbladder Cancer Using Preoperatively Available Prognosticators: A Korean Multicenter Retrospective Study.

Gallbladder cancer (GBC) is a rare and aggressive malignancy with poor prognosis and high recurrence rates, even after curative surgical resection. Early recurrence, defined as recurrence within one year after surgery, remains a major clinical concern. This study aimed to identify preoperative prognostic factors and develop a predictive model for early recurrence and overall survival in resected GBC patients.

Impact of portal/superior mesenteric vein abutment angle on prognosis in pancreatic cancer: a single-center retrospective cohort study.

Purpose: Pancreatic cancer has a poor prognosis; however, the implementation of neoadjuvant treatment enables borderline resectable cases to undergo curative resection and improves the overall survival rate. Attempts have been made to expand the eligibility criteria for neoadjuvant treatment, even in resectable cases. Some studies have suggested a correlation between vein abutment and poor prognosis or that the abutment angle may affect prognosis.

Implications of portal vein/superior mesenteric vein involvement in pancreatic cancer: A comprehensive correlation from preoperative radiological assessment to resection, pathology, and long-term outcomes. A retrospective cohort study.

Background: The incidence of portal vein/superior mesenteric vein (PV/SMV) resection during pancreatoduodenectomy is increasing in clinical practice. This study investigated the clinical significance of preoperative PV/SMV assessment and intraoperative resection and their correlation with pathological results and long-term survival outcomes.

Methods: We analyzed 443 patients undergoing pancreatoduodenectomy at a tertiary center from 2012 to 2017 based on PV/SMV resection.

Timing for a surgically safe and oncologically prompt pancreatoduodenectomy after preoperative biliary drainage in patients with bile duct cancer.

Background: Preoperative biliary drainage (PBD) is commonly performed in patients with bile duct cancer (BDC). However, data regarding the timing of pancreatoduodenectomy (PD) after PBD are insufficient. This study aimed to investigate the optimal timing for surgically and oncologically safe PD after PBD.

Prognostic Accuracy of ypTNM Stage in Patients with Pancreatic Cancer in the Era of Modern Neoadjuvant Therapy.

Background: The American Joint Committee on Cancer (AJCC) 8th edition TNM staging manual, which provided ypTNM for patients undergoing neoadjuvant therapy (NAT), has not been comparatively assessed against pTNM for prognosis in pancreatic cancer. This study aimed to compare the prognosis between ypTNM and pTNM stages.

Patients And Methods: Clinicopathological data from 586 patients who underwent pancreatic cancer surgery at a tertiary center between 2018 and 2022 were analyzed to compare survival outcomes between ypTNM and pTNM stages and identify prognostic factors.

Skeletal Muscle Index Changes on Locoregional Treatment Application After FOLFIRINOX and Survival in Pancreatic Cancer.

Background: Patients with borderline resectable (BR) or locally advanced pancreatic cancer (LAPC) require complex management strategies. This study evaluated the prognostic significance of the perichemotherapy skeletal muscle index (SMI) and carbohydrate antigen 19-9 (CA 19-9) in patients with BRPC or LAPC treated with FOLFIRINOX.

Methods: We retrospectively evaluated 227 patients with BR or LAPC who received at least four cycles of chemotherapy between 2015 and 2020.

Predicting lymph node metastasis using preoperative parameters in patients with T1 ampulla of vater cancer.

Background: Lymph node (LN) metastasis is an established prognostic factor for patients with surgically resected ampulla of Vater (AoV) cancer. The standard procedure for radical resection, including removal of regional LNs, is pancreaticoduodenectomy (PD); however, local excision has been considered as an alternative option for patients in the early stage cancer with significant comorbidities. In the present study, we elucidated the preoperative factors associated with LN metastasis to determine the appropriate surgical extent for T1 AoV cancer.

Comparison of Survival Outcomes between Radical Antegrade Modular Pancreatosplenectomy and Conventional Distal Pancreatosplenectomy for Pancreatic Body and Tail Cancer: Korean Multicenter Propensity Score Match Analysis.

(1) Background: The aim of this study was to compare the survival benefit of radical antegrade modular pancreatosplenectomy (RAMPS) with conventional distal pancreatosplenectomy (cDPS) in left-sided pancreatic cancer. (2) Methods: A retrospective propensity score matching (PSM) analysis was conducted on 333 patients who underwent RAMPS or cDPS for left-sided pancreatic cancer at four tertiary cancer centers. The study assessed prognostic factors and compared survival and operative outcomes.

Fate of small remnant pancreatic tail in splenic hilum after laparoscopic spleen preserving distal pancreatectomy: a retrospective study.

Purpose: When performing laparoscopic spleen-preserving distal pancreatectomy (LSPDP), sometimes, anatomically challenging patients are encountered, where the pancreatic tail is deep in the splenic hilum. The purpose of this study was to discuss the experience with the surgical technique of leaving the deep pancreatic tail of the splenic hilum in these patients.

Methods: Eleven patients who underwent LSPDP with remnant pancreatic tails between November 2019 and August 2021 at Samsung Medical Center in Seoul, Korea were included in the study.

Twenty-one years of experience with resected solid pseudopapillary neoplasm: a retrospective single-institutional cohort study.

Background: Although the incidence of solid pseudopapillary neoplasm (SPN) is <2% of the incidence of pancreatic tumor, the prevalence seems to be increasing. SPNs are mostly benign. However, they also show malignant features.

Pancreatic Metastasectomy for Secondary Malignancy of the Pancreas: A Single-institution Experience.

Background/aim: Metastasis to the pancreas is rare, and the benefit of resection for secondary pancreatic cancer is poorly defined. Furthermore, there are no guidelines for pancreatic metastasectomy in such patients. The purpose of this study was to discuss our experience with the operative management of secondary pancreatic cancer.

Safety and Efficacy of Neoadjuvant SABR in Pancreatic Cancer: Effect of Magnetic Resonance Imaging-Guided Respiratory-Gated Adaptive Radiation Therapy.

Purpose: We aimed to evaluate the safety and efficacy of neoadjuvant SABR using magnetic resonance imaging-guided respiratory-gated adaptive radiation therapy (MRgRg-ART) in pancreatic cancer.

Methods And Materials: We performed a single-institution retrospective review in patients with pancreatic cancer who underwent neoadjuvant SABR followed by surgical resection. After neoadjuvant chemotherapy, those considered resectable by the multidisciplinary team received SABR over 5 consecutive days using MRgRg-ART.

Survival Comparison of Different Operation Types for Middle Bile Duct Cancer: Bile Duct Resection versus Pancreaticoduodenectomy Considering Complications and Adjuvant Treatment Effects.

Background: Margin status is one of the most significant prognostic factors after curative surgery for middle bile duct (MBD) cancer. Bile duct resection (BDR) is commonly converted to pancreaticoduodenectomy (PD) to achieve R0 resection. Additionally, adjuvant treatment is actively performed after surgery to improve survival.

Different Oncologic Outcomes According to Margin Status (High-Grade Dysplasia vs. Carcinoma) in Patients Who Underwent Hilar Resection for Mid-Bile Duct Cancer.

Margin positivity after hilar resection (HR) for bile duct cancer is commonly observed due to its longitudinal spread along the subepithelial plane; nevertheless, we cannot draw conclusions regarding the prognostic effects of margins with high-grade dysplasia (HGD) or carcinoma. We aimed to investigate the oncologic effect according to the margin status after HR, particularly between the R1 HGD and the R1 carcinoma. From 2008 to 2017, 149 patients diagnosed with mid-bile duct cancer in Samsung Medical Center, South Korea, were divided according to margin status after HR and retrospectively analyzed.

Glucolipotoxicity Suppressed Autophagy and Insulin Contents in Human Islets, and Attenuation of PERK Activity Enhanced Them in an ATG7-Dependent Manner.

Backgruound: Administration of pancreatic endoplasmic reticulum kinase inhibitor (PERKi) improved insulin secretion and hyperglycemia in obese diabetic mice. In this study, autophagic balance was studied whether to mediate it.

Methods: Human islets were isolated from living patients without diabetes.